Development and evaluation of extracorporeal membrane oxygenation nursing education program for nursing students using virtual reality.

BACKGROUND: This study aims to improve nursing students' ability to care for critically ill patients through education in extracorporeal membrane oxygenation (ECMO) nursing. METHODS: This study developed a virtual reality (VR) simulation program for the five-step ECMO nursing of the Analysis, Design, Development, Implement, and Evaluation (ADDIE) model and used an equivalent control group pre-test and post-test no-synchronized design to verify the effect. The participants of this study were fourth-year nursing students enrolled in nursing departments at three universities in Seoul, Gangwon, and Gyeonggi in South Korea; it included 66 participants, 33 in each of the experimental and control groups. The program consisted of pre-training, orientation, VR simulation, and debriefing. RESULTS: The interaction effect of the intervention and control groups with time points using the ECMO nursing VR simulation program was rejected due to no statistically significant difference in knowledge (F = 1.41, p = .251), confidence (F = 1.97, p = .144), and clinical reasoning capacity (F = 2.85, p = .061). However, learning immersion (t = 3.97, p < .001) and learning satisfaction (t = 4.25, p < .001) were statistically significantly higher in the experimental group than in the control group. CONCLUSION: VR simulation program for ECMO nursing developed in this study is a potential educational method that positively affects the learning immersion and learning satisfaction of nursing students.

Development and evaluation of a virtual reality mechanical ventilation education program for nursing students.

BACKGROUND: Since COVID-19 limits safe clinical practice settings, virtual reality (VR) emerged as an alternative to practical education. Using VR simulation to learn mechanical ventilation is rare in nursing education. METHODS: This study developed a VR simulation program for mechanical ventilation care and evaluated its effects. We adopted a quasi-experiment design. Participants were fourth-year students across nursing colleges in South Korea. RESULTS: The interaction effect of the intervention time point and control group, to which the VR simulation program was applied, showed a significant difference in self-efficacy (F = 19.54, p < .001) and clinical reasoning capacity (F = 16.97, p < .001). Learning satisfaction of the experimental group was statistically significantly higher than that of the control group(F = 5.22, p = .026). The level of learning immersion (t = - 3.13, p = .003) and learning satisfaction (t = - 3.49, p = .001) were statistically significantly higher in the experimental group than in the control group. CONCLUSION: These findings confirmed that the VR stimulation program for nursing students had a positive effect on their self-efficacy, clinical reasoning capacity, and learning satisfaction. Furthermore, it was effective in improving their nursing competence.

Analysis of the effect of an artificial intelligence chatbot educational program on non-face-to-face classes: a quasi-experimental study.

BACKGROUND: Education and training are needed for nursing students using artificial intelligence-based educational programs. However, few studies have assessed the effect of using chatbots in nursing education. OBJECTIVES: This study aimed to develop and examine the effect of an artificial intelligence chatbot educational program for promoting nursing skills related to electronic fetal monitoring in nursing college students during non-face-to-face classes during the COVID-19 pandemic. DESIGN: This quasi-experimental study used a nonequivalent control group non-synchronized pretest-posttest design. METHODS: The participants were 61 junior students from a nursing college located in G province of South Korea. Data were collected between November 3 and 16, 2021, and analyzed using independent t-tests. RESULTS: The experimental group-in which the artificial intelligence chatbot program was applied-did not show statistically significant differences in knowledge (t = -0.58, p = .567), clinical reasoning competency (t = 0.75, p = .455), confidence (t = 1.13, p = .264), and feedback satisfaction (t = 1.72, p = .090), compared with the control group; however, its participants' interest in education (t = 2.38, p = .020) and self-directed learning (t = 2.72, p = .006) were significantly higher than those in the control group. CONCLUSION: The findings of our study highlighted the potential of artificial intelligence chatbot programs as an educational assistance tool to promote nursing college students' interest in education and self-directed learning. Moreover, such programs can be effective in enhancing nursing students' skills in non-face-to face-situations caused by the ongoing COVID-19 pandemic.

Prediction model study of overweight and obesity in preschool children with allergic diseases from an ecological perspective.

BACKGROUND: Allergic diseases have a high incidence in childhood and a high chance to be carried over into adulthood unless appropriately treated during childhood, it is important that healthcare providers actively manage these diseases. This study was to identify multidimensional factors that affect weight gain in preschool children with allergic diseases. METHODS: The overweight and obesity prediction model for children with allergic diseases was analyzed using multiple logistic regression analysis and a decision tree model and the present study was a secondary data analysis study that used data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. RESULTS: The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases, which found that children (gender, sitting time during weekdays, sleeping hours during weekends,), parent (education level, mother's job, quality of the home environment), local community (convenience of local community facilities, satisfaction level with local community facilities, quality of childcare in the local community) characteristics affected overweight and obesity at multidimensional levels as risk factors. CONCLUSIONS: The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases using the data of the Panel Study on Korean Children, which found that children, parent, local community characteristics affected overweight and obesity at multidimensional levels as risk factors.

Actor and partner effects of parenting stress and co-parenting on marital conflict among parents of children with atopic dermatitis.

BACKGROUND: It is important for healthcare providers to pay attention to parents' rearing style and children's physical symptoms to promote a healthy quality of life among children with atopic dermatitis. We aimed to identify effects of parenting stress and co-parenting on marital conflict among parents of children with atopic dermatitis. METHODS: Participants were 161 fathers and 161 mothers raising seven-year-old children treated for atopic dermatitis. To confirm the effects of parenting stress and co-parenting on marital conflict, the "actor-partner interdependence mediation model" was used. To verify goodness-of-fit, maximum likelihood method was used, and a confirmatory factor analysis was conducted to confirm the validity of latent variables for model analysis. RESULTS: Fathers' parenting stress had actor (ß = -.46, p < .001) and partner (ß = -.22, p < .001) effects on co-parenting, and mothers' parenting stress had actor (ß = -.20, p < .001) and partner (ß = -.36, p < .001) effects on co-parenting. Fathers' parenting stress only had an actor effect on marital conflict (ß = .32, p < .001). Father's co-parenting had actor (ß = -.29, p < .001) and partner (ß = -.22, p < .001) effects on marital conflict, and mothers' co-parenting had actor (ß = -.39, p < .001) and partner (ß = -.19, p < .001) effects on marital conflict. There were significant differences between the two groups concerning three path coefficients: fathers' parenting stress affected fathers' marital conflict, fathers' co-parenting affected fathers' marital conflict, and mothers' co-parenting affected fathers' marital conflict. CONCLUSIONS: It is vital for healthcare providers to seek ways to reduce the marital conflicts of parents of children with atopic dermatitis, including further examination of the role of co-parenting, to address children's physical symptoms and promote their health. Our findings inform management and intervention programs for the families of children with atopic dermatitis.

The effects of hardcore smokers' depression and self-esteem on daily smoking amount.

BACKGROUND: This is a secondary data analysis designed as a longitudinal study aimed at investigating the effects of depression and self-esteem on daily smoking amounts among hardcore smokers over time. METHODS: The subjects of this study were 264 hardcore smokers aged 19 years or older who participated in all waves of the 9th-13th Korea Welfare Panel Studies. Self-report questionnaires were used to collect data. Data analyses were performed using SPSS WIN 24.0 and AMOS 18.0, and data were analyzed using a latent growth model. RESULTS: The intercept of depression and self-esteem among the subjects had statistically significant effects on the intercept of the daily smoking amount. The slope of depression and self-esteem among the subjects also had statistically significant effects on the slope of the daily smoking amount. The slope of depression indirect affected the slope of daily smoking amount via the level of self-esteem. CONCLUSION: It is important to determine the initial levels and the rates of change of depression, self-esteem, and daily smoking amount among hardcore smokers. In order to reduce the daily smoking amount among hardcore smokers, interventions for depression and methods to improve self-esteem among hardcore smokers should be considered.

An Exploratory Analysis of the Roles of Nurses on a Pediatric Rehabilitation Unit in South Korea Perceived by Pediatric Rehabilitation Professionals.

Rehabilitation addresses not only children's disabilities but also their physical, psychological, social, and cultural impairments. Hence, pediatric rehabilitation adopts a multidisciplinary approach; it encompasses the vital role of not only physicians and rehabilitation therapists, but also of nurses. This study conducts a content analysis of the experiences of healthcare professionals specializing in pediatric rehabilitation to explore the roles nurses working on pediatric rehabilitation units are expected to perform. After analyzing the interviews with 12 experts in pediatric rehabilitation, the roles of pediatric rehabilitation nurses were broadly categorized into five areas (caregivers, team members, counselors, researchers, and educators) with eight sub-groups and 24 specific roles. This study is significant because it provides profound insights into the roles of pediatric rehabilitation nurses in Korea. These insights can serve as foundational data for formulating policies for healthcare personnel in pediatric rehabilitation, and provide evidence for establishing a much-needed system for certified rehabilitation nurses in Korea.

Serial Dual Mediating Effects of Parenting Stress on Life Satisfaction among Parents of School-Aged Children with Chronic Conditions.

This study examines the serial dual mediating effects of marital conflict and self-esteem on the relationship between parenting stress and life satisfaction in parents of school-aged children with chronic conditions. This study aims to present foundational data for developing nursing interventions for parents caring for children with chronic illnesses. Of the 2150 parents who participated in the 13th Panel Study on Korean Children (PSKC), 271 raising a child with a chronic illness were enrolled in the study. The serial dual mediating effect was analyzed using PROCESS macro Model 6. The serial dual mediating effects of parenting stress, marital conflict, and self-esteem on parents' life satisfaction were analyzed. Marital conflict and self-esteem had significant serial multiple mediating effects on the relationship between stress and life satisfaction in fathers (B = -0.11, bootstrap 95% CI = -0.16--0.06) and mothers (B = -0.06, bootstrap 95% CI = -0.09--0.03). Our results suggest that marital conflict increases with increasing parenting stress and that increased marital conflict sequentially reduces self-esteem, ultimately diminishing life satisfaction in parents raising a child with a chronic condition. Thus, relevant nursing interventions and social support are essential to boost the life satisfaction of parents raising children with chronic conditions.

Spatiotemporal Control of Inflammatory Lytic Cell Death Through Optogenetic Induction of RIPK3 Oligomerization.

Necroptosis is a programmed lytic cell death involving active cytokine production and plasma membrane rupture through distinct signaling cascades. However, it remains challenging to delineate this inflammatory cell death pathway at specific signaling nodes with spatiotemporal accuracy. To address this challenge, we developed an optogenetic system, termed Light-activatable Receptor-Interacting Protein Kinase 3 or La-RIPK3, to enable ligand-free, optical induction of RIPK3 oligomerization. La-RIPK3 activation dissects RIPK3-centric lytic cell death through the induction of RIPK3-containing necrosome, which mediates cytokine production and plasma membrane rupture. Bulk RNA-Seq analysis reveals that RIPK3 oligomerization results in partially overlapped gene expression compared to pharmacological induction of necroptosis. Additionally, La-RIPK3 activates separated groups of genes regulated by RIPK3 kinase-dependent and -independent processes. Using patterned light stimulation delivered by a spatial light modulator, we demonstrate precise spatiotemporal control of necroptosis in La-RIPK3-transduced HT-29 cells. Optogenetic control of proinflammatory lytic cell death could lead to the development of innovative experimental strategies to finetune the immune landscape for disease intervention.

Analyzing Korean Public Health Centers' Infectious Disease Disaster Response Experiences with a Focus on Business Continuity.

Objective: This study aims to provide basic data for establishing strategies to maintain the core functions of health centers, and enable an effective response to emergency tasks in the event of future infectious disease disasters. Methods: The participants were 41 workers from two public health centers in Seoul. They all had prior experience in responding to the early and middle stages of the COVID-19 pandemic. Data were collected through Focus Group Discussions, and then analyzed using the deductive method of content analysis. Results: The participants' experiences during the infectious disease disaster crisis were examined through ten categories: governance and coordination, information management, human resources, essential medical supplies and equipment, infrastructure, administration, finance and logistics, community engagement and risk communication, delivery of essential services, security, and additional considerations for vulnerable populations. The analysis of the results made it apparent that new systems and policies were imperative for responding appropriately to the concerns and experiences of the public healthcare center staff, and for improving the response to future epidemics. Conclusion: We found that to prepare for infectious disaster situations in the future, it is necessary for health centers to establish a mid- to long-term business continuity plan to ensure the continuation and stability of their operations. Additionally, it was found that health professionals in public health centers also believe in the necessity of education and training programs on disaster preparedness, based on Business Continuity Planning proposed by the World Health Organization. They deem these essential to sustain routine tasks for the management of the health of local community residents during outbreaks of novel infectious diseases in the future.

Obesity-Related Factors in Adult Women with Early Menarche.

The average menarche age among South Korean women has decreased over time. Early menarche in women causes a higher incidence of obesity owing to the continuous fat accumulation induced by prolonged exposure to estrogen and adrenal steroids. Identifying the factors affecting obesity in women who experience early menarche is essential for managing obesity in adult women. This study aimed to analyze the factors associated with obesity in adult women who experienced early menarche and to provide basic data for obesity management. This study was a cross-sectional and descriptive survey from the seventh Korea National Health and Nutrition Examination. A total of 371 women aged ≥ 19 years experienced early menarche, and the propensity matching method was used to analyze the obesity-related factors identified in previous studies. The results showed that obesity in adult women with early menarche was negatively associated with the level of aerobic exercise (OR = 0.53, 95% CI = 0.30-0.93, p = 0.028) and muscle-strengthening exercise (OR = 0.33, 95% CI = 0.17-0.64, p = 0.001). Future longitudinal studies on girls who experience early menarche are needed to address female obesity prevention at every stage of life, and, based on these findings, obesity management programs can be developed and applied and their effectiveness determined.

Topic Modeling-Based Analysis of News Keywords Related to Patients with Diabetes during the COVID-19 Pandemic.

This study analyzed major issues related to diabetes during the coronavirus disease (COVID-19) pandemic by using topic modeling analysis of online news articles provided by BIGKind dating from 20 January 2020, the onset of the COVID-19 outbreak in Korea, to 17 April 2022, the lifting of the social distancing restrictions. We selected 226 articles and conducted topic modeling analysis to identify the main agenda of news related to patients with diabetes in the context of the COVID-19 pandemic; both latent Dirichlet allocation and visualization were conducted by generating keywords extracted from news text as a matrix using Python 3.0. Four main topics were extracted from the news articles related to "COVID-19" and "diabetes" during the COVID-19 pandemic, including "COVID-19 high-risk group," "health management through digital healthcare," "risk of metabolic disease related to quarantine policy," and "child and adolescent obesity and diabetes." This study is significant because it uses big data related to diabetes that was reported in the mass media during the new epidemic to identify problems in the health management of patients with diabetes during a new epidemic and discuss areas that should be considered for future interventions.

The clinical potential of optogenetic interrogation of pathogenesis.

BACKGROUND: Opsin-based optogenetics has emerged as a powerful biomedical tool using light to control protein conformation. Such capacity has been initially demonstrated to control ion flow across the cell membrane, enabling precise control of action potential in excitable cells such as neurons or muscle cells. Further advancement in optogenetics incorporates a greater variety of photoactivatable proteins and results in flexible control of biological processes, such as gene expression and signal transduction, with commonly employed light sources such as LEDs or lasers in optical microscopy. Blessed by the precise genetic targeting specificity and superior spatiotemporal resolution, optogenetics offers new biological insights into physiological and pathological mechanisms underlying health and diseases. Recently, its clinical potential has started to be capitalized, particularly for blindness treatment, due to the convenient light delivery into the eye. AIMS AND METHODS: This work summarizes the progress of current clinical trials and provides a brief overview of basic structures and photophysics of commonly used photoactivable proteins. We highlight recent achievements such as optogenetic control of the chimeric antigen receptor, CRISPR-Cas system, gene expression, and organelle dynamics. We discuss conceptual innovation and technical challenges faced by current optogenetic research. CONCLUSION: In doing so, we provide a framework that showcases ever-growing applications of optogenetics in biomedical research and may inform novel precise medicine strategies based on this enabling technology.

Spectral reflectivity recovery from the tristimulus values using a hybrid method.

This study proposes an effective and accurate mechanism for spectral reflectivity recovery based on a hybrid technique. Adaptive non-negative matrix transformation, three-dimensional interpolation, and two-dimensional interpolation were reconstructed to an integrative hybrid recovery method. The existing spectral reflectivity data of 1269 Munsell matte color chips were used as reference data. Under the standard condition of a D65 illuminant and a 10° observer of 1964 CIE, the spectral reflectivity of the 1269 Munsell colors was reconstructed successfully using the optimized hybrid recovery method. The root mean square error and goodness of fitting were used to determine the quality of the presented method. Using the hybrid method, the strategy for fast and reliable spectral reflectivity recovery of given images were also presented and demonstrated.

A study on related factors of hardcore smokers.

AIM: This study attempted to provide basic data for future smoking cessation policies and anti-smoking programs by analyzing related factors of hardcore smokers. METHODS: This study is a cross-sectional, descriptive survey of the 2019 Community Health Survey conducted by the Korean Ministry of Health and Welfare. There were 11,817 smokers, and the propensity matching method was used based on factors related to hardcore smokers in previous studies. RESULTS: Consequently, a higher probability to be included as hardcore smokers was observed in subjects who had a higher level of stress perception (odds ratio [OR] = 17.59, 95% CI [10.18, 30.38]), perceived their body shape as chubby (OR = 12.84, 95% CI [8.39, 19.66]) or obese (OR = 7.03, 95% CI [4.90, 10.09]), walking participation rate for more than 10 min a day (OR = 1.09, 95% CI [1.03, 1.15]), and had a high degree of depression (OR = 1.43, 95% CI [1.37, 1.49]). CONCLUSION: It is necessary to approach smoking-related policies separately between general and hardcore smokers. Finally, more effective smoking cessation policies must be found by identifying the characteristics of hardcore smokers.

Latent Class Analysis of Decompression Sickness Symptoms of Women Divers.

This study aimed to investigate the types of clinical manifestations of decompression sickness among women divers (haenyeos) in Jeju using latent class analysis and to identify factors related to the condition. A total of 527 haenyeos who received their certification in diving fishery from Jeju and were working from 15 March to 31 May 2021 were included in this study. According to the results of the study, the latent classes were classified into type 1, type 2, and mixed symptoms groups (Akaike information criterion (AIC) = 6587.29, Bayesian information criterion (BIC) = 6698.23, sample size-adjusted BIC (saBIC) = 6615.70). For personal characteristics, age (χ2 = 40.31, p < 0.001) and education level (χ2 = 28.15, p < 0.001) showed a significant difference by latent class type. For work-related characteristics, diving experience (χ2 = 29.99, p < 0.001) and break time (χ2 = 9.32, p = 0.011) showed a significant difference by latent class type. The health-related characteristics, menopausal period (χ2 = 40.10, p < 0.001), body mass index (χ2 = 14.80, p = 0.013), and fatigue level (χ2 = 58.23, p < 0.001), showed a significant difference by latent class type. Rather than approaching the management of work-related diseases simply from the work environment perspective, it is important to increase the availability of health professionals who are capable of continuous health monitoring and management of women divers in their workplace.

Development and evaluation of virtual reality simulation education based on coronavirus disease 2019 scenario for nursing students: A pilot study.

AIM: This research is designed to establish and evaluate the effectiveness of a virtual reality simulation program using COVID-19 scenario for nursing students. DESIGN: This is a quasi-experimental study using a non-equivalent control group pre-test-posttest design. METHODS: The participants were 65 students in their fourth year in nursing college. The knowledge about communicable infectious diseases in the respiratory system, self-efficacy, clinical reasoning capacity and learning satisfaction was evaluated. RESULTS: The experimental group showed a significantly higher learning satisfaction (t = 3.01, p = .004). Both groups presented statistically significant differences in knowledge on infectious respiratory diseases, self-efficacy and clinical reasoning between pre-test and posttest. However, knowledge (t = 0.47, p = .643), self-efficacy (t = 0.70, p = .944) and clinical reasoning were not different between the groups.

Depression with Chronic Disease Is Associated with Increased Use of Medical Services and Medical Expenses in Hardcore Smokers.

We aimed to investigate the association of chronic disease and depression with medical service use and expenses in hardcore smokers and provide basic data for health management system of hardcore smokers. This was a secondary data study involving 1735 smokers. Propensity score matching (PSM) was conducted to match hardcore smokers with regular smokers, and a two part model (TPM) was used based on the matched groups. In the case of general smokers, subjects with both depression and chronic disease had a significant relation to medical service use. In the case of hardcore smokers, subjects without depression and with chronic disease or with both depression and chronic disease had increased the use of medical services. The depression and chronic disease of general smokers did not affect the use of medical services. In the case of hardcore smokers, subjects who do not have depression and have only chronic disease (ß = 0.20, p = 0.002) or with depression and chronic disease (ß = 0.20, p = 0.014) significantly related the use of medical services. Conclusion: It is necessary to establish a health management system that considers both emotional states and chronic disease for hardcore smokers.

Effect of exposure to COVID-19 infodemic on infection-preventive intentions among Korean adults.

AIM: This study determined the effect of exposure to coronavirus disease 2019 (COVID-19) infodemic on infection-preventive intentions among Korean adults. DESIGN: This was a cross-sectional study that used structural equation model. METHODS: Data were collected between 14 April-7 July 2020 from 300 adults in their 20s to 60s residing in South Korea. Analysis was performed using SPSS 20.0 and AMOS 20.0. RESULTS: Exposure to COVID-19 infodemic had a direct effect on the reduction of COVID-19-related knowledge and personal preventive health intentions. COVID-19-related knowledge had a direct impact on increased perceived severity, perceived vulnerability, perceived self-efficacy, and personal preventive health intentions. Perceived severity, perceived vulnerability, and perceived self-efficacy had a direct effect on increasing preventive intentions for personal health; and perceived severity had a direct effect on preventive intentions for public health.

A Study of the Educational Needs of Clinical Nurses Based on the Experiences in Training Programs for Nursing COVID-19 Patients.

PURPOSE: This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs. METHODS: Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19. RESULTS: Participants' experiences were classified into three major categories, namely "Participation experiences and perceptions of the training program," "Recommendations for improving the training program," and "Perceptions of working in an infectious environment," and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for "nursing care for patients on extracorporeal membrane oxygenation" and "application of continuous renal replacement therapy and caring for patients." CONCLUSION: To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses' educational needs and basic educational materials for nursing students. TRIAL REGISTRATION: CRIS, KCT0006359. Registered 20 July 2021 - Retrospectively registered, https://cris.nih.go.kr/cris/.